Steinke John W, Borish Larry
Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
Carter Immunology Center, University of Virginia Health System, Charlottesville, VA, USA.
Curr Allergy Asthma Rep. 2016 Nov;16(11):78. doi: 10.1007/s11882-016-0661-2.
Acute asthma exacerbations are responsible for urgent care visits and hospitalizations; they interfere with school and work productivity, thereby driving much of the morbidity and mortality associated with asthma. Approximately 80 to 85 % of asthma exacerbations in children, adolescents, and less frequently adults are associated with viral upper respiratory tract viral infections, and rhinovirus (RV) accounts for ∼60-70 % of these virus-associated exacerbations. Evidence suggests that it is not the virus itself but the nature of the immune response to RV that drives this untoward response. In particular, evidence supports the concept that RV acts to exacerbate an ongoing allergic inflammatory response to environmental allergens present at the time of the infection. The interaction of the ongoing IgE- and T cell-mediated response to allergen superimposed on the innate and adaptive immune responses to the virus and how this leads to triggering of an asthma exacerbation is discussed.
急性哮喘加重导致急诊就诊和住院；它们干扰学校学习和工作效率，从而导致许多与哮喘相关的发病和死亡。儿童、青少年以及较少见的成人中，约80%至85%的哮喘加重与病毒性上呼吸道感染有关，而鼻病毒（RV）占这些病毒相关加重病例的约60% - 70%。有证据表明，驱动这种不良反应的并非病毒本身，而是对RV的免疫反应性质。特别是，有证据支持这样的概念，即RV会加剧对感染时存在的环境过敏原的持续过敏性炎症反应。本文讨论了正在进行的IgE和T细胞介导的对过敏原的反应与对病毒的固有和适应性免疫反应相互叠加的情况，以及这如何导致哮喘加重的触发。
